Aerobic capacity in early paraplegia: implications for rehabilitation

Both strength (ability to develop tension) and endurance (aerobic capacity as measured by VO2 max) contribute to overall functional capacity. In the rehabilitation of individuals with major neuromuscular deficits such as paraplegia, primary emphasis is generally placed on strength training to develop functional independence. However, endurance training may also be important. To clarify the influence of paraplegia on the VO2, we studied 10 paraplegics between 2 to 12 weeks after injury to determine whether or not a deficit in arm VO2 max was present before the inception of a conventional rehabilitation programme, and whether it persisted in three subjects after its completion. Cardiorespiratory responses to progressive multi-stage arm ergometry were measured using standard open circuit calorimetry. Ten paraplegic subjects demonstrated a low VO2 max compared to control subjects. This deficit persisted when selected subjects (n = 3) were tested after completion of a conventional rehabilitation programme which emphasised strengthening exercises. Further research is needed to study the effects of complementary endurance training on the aerobic capacity as measured by VO2 max, and to assess their value in the rehabilitation process.